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Julie Perilloux

A Pair of Ears Travel

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  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h1" label="Walt Disney World - MNSSHP Quote Form&amp;nbsp;"/>&#13;
		<field type="header" subtype="h1" label="Lead Guest Information&amp;nbsp;"/>&#13;
		<field type="text" required="true" label="First name" name="first-name" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Last name" name="last-name" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Email" name="email" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="What is the date of the party you would like to attend? (MM/DD/YYYY)" description="First Choice" name="what-is-the-date-of-the-party-you-would-like-to-attend-mmddyyyy" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="How many adult tickets?&amp;nbsp; (10 years and up)" name="text-1747266013404" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="How many kid tickets? (ages 3-9)" description="First Choice" name="text-1747266015884" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" required="true" label="Are you Annual Passholder or DVC?" name="are-you-annual-passholder-or-dvc">&#13;
			<option label="Annual Passholder" value="annual-passholder">Annual Passholder</option>&#13;
			<option label="Disney Vacation Club" value="disney-vacation-club">Disney Vacation Club</option>&#13;
			<option label="None of the above " value="none-of-the-above-">None of the above </option>&#13;
		</field>&#13;
		<field type="header" subtype="h1" label="Reminder&amp;nbsp; - Full Payment is due at time of booking for ticket only purchases. Kids 2 and under do not require a party ticket.&amp;nbsp; &amp;nbsp;"/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>